| Doctor Name: | DIANE M KELLY |
| NPI Number: | 1083783278 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | F335005 |
| Business Practice Address: | 8 Denison Pkwy E Suite 201 Corning, NY - 148302638 |
| Business Phone Number: | 6079364143 |
| Business Fax Number: | 6079366836 |
| Mailing Address: | 571 Saint Josephs Blvd Fl 2, ELMIRA |
| State: | NY |
| Postal Code: | 149013230 |
| Phone Number: | 6072712050 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 06/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | F335005 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |